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Cited by 127Suicide and Self-Harm StudiesTreatment of Major DepressionMental Health Treatment and Access

Inadequacy of Antidepressant Treatment for Patients With Major Depression Who Are at Risk for Suicidal Behavior

Oquendo, Maria A., Malone, Kevin M., Ellis, Steven P., Sackeim, Harold A., Mann, J. John·1999·American Journal of Psychiatry
DOI 10.1176/ajp.156.2.190
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Abstract

OBJECTIVE: The authors' goal was to determine whether suicide attempters with major depression received more intensive antidepressant treatment than depressed patients who had not attempted suicide. METHOD: One hundred eighty inpatients who met DSM-III-R criteria for a major depressive episode according to the Structured Clinical Interview for DSM-III-R were enrolled in the study. All patients were assessed for lifetime history of suicide attempts. Depressive symptoms at the index hospitalization were assessed with the Hamilton Depression Rating Scale and the Beck Depression Inventory. Strength of antidepressant treatment over the 90 days preceding the hospitalization was scored by using the Antidepressant Treatment History Form. RESULTS: A large majority of the depressed patients with a history of suicide attempts, who were at higher risk for future suicide and suicide attempts, received inadequate treatment. Similarly, most of the depressed patients at lower risk for suicide attempts also received inadequate treatment. CONCLUSIONS: Major depression is undertreated pharmacologically, regardless of history of suicide attempt. Some suicide attempts may be preventable if the problem of underdiagnosis and undertreatment of depression can be overcome by psychoeducation for health professionals and the public.

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  • Major depressive episodes account for about 60% of psychiatric diagnoses in suicide decedents, and major depressive episodes are mostly untreated at the time of death.

    “Major depressive episodes account for about 60% of psychiatric diagnoses in suicide decedents (218), and major depressive episodes are mostly untreated at the time of death (219).”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [219]

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Authors
Oquendo, M. A., Malone, K. M., Ellis, S. P., Sackeim, H. A., & Mann, J. J.
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1999-02-01
Volume
156
Issue
2
Pages
190-194
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.156.2.190
OpenAlex
W1876667569
Cited by
127
References
30
Citations by year
2024: 2 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 2
FWCI
12.24
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (MH35636, R01MH040695, MH46745, MH 40695)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
major depressive disorder, antidepressant treatment, treatment adequacy, suicide attempts, suicide risk, undertreatment of depression, hospitalized patients, psychoeducation, underdiagnosis of depression
MeSH terms
Adult, Age Factors, Analysis of Variance, Antidepressive Agents, Depressive Disorder, Drug Administration Schedule, Female, Hospitalization, Humans, Male, Personality Inventory, Psychiatric Status Rating Scales, Regression Analysis, Retrospective Studies, Risk Factors, Sex Factors, Suicide, Attempted, Treatment Outcome

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